title: Pros and cons of catheter lock solutions.
abstract: OBJECTIVE
  Catheter-related bacteremia (CRB) and catheter dysfunction are major sources of morbidity and mortality when central venous catheters are used as long-term vascular access in hemodialysis patients. Attempts have been made to minimize these complications by the prophylactic use of catheter locking solutions. This review aims to describe the recent advances in the field of lock solutions and to discuss the benefits and risks associated with the routine use of antimicrobial and/or antithrombotic lock solutions.
  
  
  RESULTS
  Antithrombotic lock solutions may improve patency and CRB but may be cost-prohibitive. Antimicrobial lock solutions may decrease the incidence of CRB, but their routine use is concerning for the risk of systemic toxicity and the development of resistant organisms. Preliminary results suggest a novel antimicrobial and antithrombotic lock solution may be promising in maintaining patency, while decreasing catheter-related bacteremia.
  
  
  CONCLUSIONS
  The ideal catheter lock solution would be one that prevents infections and thrombosis safely and effectively, while being economically viable. Recent developments have led to improvements in the development of catheter locking solutions, but the search for the perfect 'solution' is still ongoing.
authors.affiliation: aDivision of Nephrology, Emory University, Atlanta, Georgia, United States bDivision of Nephrology, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Vandana D
authors.initials: VD
authors.lastname: Niyyar
authors.forename: Charmaine E
authors.initials: CE
authors.lastname: Lok
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000009:adverse effects; D016470:Bacteremia / Q000517:prevention & control; D055499:Catheter-Related Infections / Q000517:prevention & control*; D002405:Catheterization, Central Venous / Q000009:adverse effects* / Q000379:methods*; D019343:Citric Acid / Q000008:administration & dosage / Q000009:adverse effects; D000431:Ethanol / Q000008:administration & dosage / Q000009:adverse effects; D005343:Fibrinolytic Agents / Q000008:administration & dosage / Q000009:adverse effects; D006493:Heparin / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D006435:Renal Dialysis / Q000009:adverse effects / Q000379:methods; D012996:Solutions; D062666:Vascular Access Devices / Q000009:adverse effects
chemical_list: D000900:Anti-Bacterial Agents; D005343:Fibrinolytic Agents; D012996:Solutions; D019343:Citric Acid; D000431:Ethanol; D006493:Heparin